Irritable bowel syndrome (IBS) can cause severe gastrointestinal discomfort and affect your quality of life. People with IBS often feel too embarrassed or uncomfortable to talk about their symptoms—but speaking with a doctor can be the first step to finding relief.

If you suspect that IBS could be the cause of your abdominal pain and discomfort, there’s a good chance you’re right—it’s one of the most commonly diagnosed gastrointestinal (GI) conditions in the US. It’s estimated that 10-15% of adults in the US suffer from IBS, and it’s cited as one of the most common causes for missed days at work behind the common cold.

Dr. David R. Heiman, a gastroenterologist at Florida Medical Clinic Orlando Health, explains what irritable bowel syndrome is, its symptoms, and how IBS is diagnosed and treated by a doctor. 

What is IBS?

Irritable bowel syndrome (IBS) is a functional gastrointestinal condition. “Functional” means IBS is caused by problems with the way your brain and gut work together. The exact causes of IBS aren’t clear, but scientists think it may be related to bacterial growth in the gut, food sensitivities, and genetic factors.

Irritable bowel syndrome is often classified into one of three types:

• IBS-C (IBS with constipation). It may be very hard to have a bowel movement. People with IBS-C may struggle with feeling “blocked” or bloated even after going to the bathroom.
• IBS-D (IBS with diarrhea). You may have many bowel movements throughout the day, often accompanied by an urgent need to go and stool that is loose and watery.
• IBS-M (IBS with mixed symptoms). The consistency of your bowel movements may change day-to-day.

IBS is most common in people under the age of 50 and more common in women than men. People with mental health issues, like anxiety and/or depression, are also more likely to have IBS.

Symptoms of IBS

Irritable bowel syndrome involves gastrointestinal symptoms, which can vary from person to person. Some of the most common symptoms of IBS include:

• Abdominal pain for at least one day per week over the past three months
• Frequent diarrhea, frequent constipation, or both
• Feeling the urgent need to go
• Feeling bloated
• Mucus in your stool (may be clear, white, yellow, or greenish)

Some patients may experience IBS attacks (also called IBS flare-ups). These are periods characterized by a sudden increase in symptoms that can last hours, days, or even longer. If you experience an IBS attack that won’t seem to calm down or leads to any “alarm” symptoms, call your doctor.

Watch Out for More Serious “Alarm Symptoms”

There are certain “red flag” or “alarm” symptoms associated with IBS. These are symptoms of a more serious condition that require immediate medical attention. Call your doctor right away if you’re experiencing:

• Sudden, unexplained weight loss
• Blood in your stool
• A sudden or dramatic change in your symptoms (such as feeling new pain or constipation/diarrhea getting much worse)
• Symptoms that wake you up at night
• New gastrointestinal symptoms if you’re over 50

These can be an indication that something else is going on in your gut, like an infection.

How is IBS diagnosed by a doctor?

To diagnose IBS, your doctor will primarily ask you about your symptoms and their frequency. It can be hard for some people to talk about GI problems with their doctor, but being open and honest with your physician is the best way for them to diagnose your symptoms and make a treatment plan that works for you.

Your doctor may ask questions like:

• What kinds of gastrointestinal symptoms are you experiencing?
• How frequently do you experience symptoms? Do they come and go, or do they happen almost every day?
• Are symptoms triggered by certain foods?
• Do you notice symptoms appearing during or after times of stress?
• Do you have a family history of IBS or other gastrointestinal conditions?

Currently, there are no laboratory tests that can diagnose IBS. However, your doctor may recommend you receive certain tests (such as blood tests, an X-ray, or colonoscopy) in order to rule out other possible causes for your symptoms.

Doctors diagnose IBS based on your history of symptoms and a lack of evidence of other conditions. If you’re concerned that your abdominal pain may be IBS, talk to your doctor.

How is IBS Treated?

Irritable bowel syndrome is not a condition that can be permanently cured, but there are ways to alleviate symptoms and prevent future IBS attacks. Some patients find that a combination of treatments is the best way to manage their IBS.

It may take time to find a treatment plan that works best for you. Never stop or start a medication or diet without first talking to your doctor to make sure it’s safe.

Dietary Changes

One of the most common ways that doctors recommend controlling IBS symptoms is by changing the things you eat. That being said, there’s no single IBS diet plan that works for all patients. What’s right for you will depend on the type of IBS you have and what kinds of foods trigger your symptoms.

Some examples of IBS diet plans include:

• Getting more fiber. Taking soluble fiber supplements or eating fiber-filled foods can alleviate symptoms in some people. However, some patients may find that taking in extra fiber makes their symptoms worse. Talk to your doctor before starting any fiber supplement.
• Trying a low FODMAP diet. A low FODMAP diet is designed to cut out gas-causing foods. This highly restrictive diet is temporary and intended to help patients figure out if certain foods cause symptoms as they are slowly reintroduced.
• Avoiding dairy products. The lactose in milk, yogurt, and cheese can make GI symptoms worse in patients who are lactose intolerant. Avoiding dairy products may help some patients.
• Avoiding gluten. Research has shown that there’s some overlap between people who are non-Celiac gluten sensitive and people who experience IBS. Reducing or eliminating sources of gluten may help some patients.

Do not start a new diet plan without consulting a registered nutritionist or physician first. A doctor or nutritionist can help ensure you’re still getting the nutrition you need to be healthy even while restricting some foods.

Medications for Irritable Bowel Syndrome

Your doctor may prescribe you medication to help ease your IBS symptoms. 

• Laxatives. Laxatives can help relieve occasional constipation in patients with IBS-C. However, laxatives can be harmful if taken every day, so it’s important to talk with your doctor before taking them to treat IBS.
• Antidiarrheal medications. For patients with IBD-D who experience diarrhea regularly, over-the-counter antidiarrheal medications like loperamide can help prevent watery stools. Again, even though these drugs are available OTC, it’s recommended that you speak with your doctor before using them.
• IBS medications. There are a variety of medications designed specifically for IBS. These include antispasmodics to reduce pain and drugs to control bacterial overgrowth in the gut.
• Dietary supplements/probiotics. Some fiber supplements and probiotics may help manage symptoms and promote good gut microbiome health. Only take supplements or probiotics under the supervision of a doctor.
• Antidepressants and/or anti-anxiety medication. If your IBS is exacerbated by depression or anxiety (or is even the cause of depression or anxiety), your doctor may recommend you try medication to help regulate your mood.

Using Cognitive Behavioral Therapy to Treat IBS

When IBS is caused by stress or is a major cause of stress, seeing a psychologist or therapist for your mental health can help. A therapist can help you develop techniques to manage stress and tackle issues in your life that may be at the root of depression and/or anxiety.

While stress and anxiety aren’t the only factors that play into IBS, stress can aggravate symptoms and make them worse. Many patients find relief by combining dietary changes and medication with therapy.

If You Think You May Have IBS, Schedule a Visit With a Gastroenterologist

Irritable bowel syndrome does not have to control your life. With the right treatments, it’s possible to reduce symptoms and prevent flare-ups. If you’re looking for a doctor who can diagnose IBS or you need help getting your symptoms under control, schedule an appointment with Dr. Heiman in Tampa, FL, today.

About Dr. Heiman

A USF alum, Dr. David R. Heiman is a gastroenterologist and Endoscopy Medical Director at Florida Medical Clinic Orlando Health’s North Tampa campus. Dr. Heiman is dedicated to treating patients with GI disorders and helping them find relief from their symptoms. He specializes in treating and diagnosing IBS, GERD, hepatitis, and liver disease, as well as performing colon cancer screenings and endoscopies.

Disclaimer: This blog is not intended to substitute professional medical advice. Always talk with your doctor before starting or stopping medications or treatments.